The Effect of PIP Reform on Examinations Under Oath and Independent Medical Examinations

Posted By Robert Sparks || May 16, 2012

In previous blog posts we have addressed some of the statutory changes to the laws related to Personal Injury Protection (PIP) benefits. As previously discussed, the PIP reforms will impact victim’s medical benefits and related coverages.

In addition to the above, PIP reform will also change the investigation and payment of claims. These reforms may also have a limiting effect on individual’s rights to obtain PIP benefits.

Under the provisions related to the investigation of PIP claims by insurers (effective January 1, 2013), insurers are now authorized to take an examination under oath (EUO) of an insured. This authorization is a condition precedent to receiving benefits which means the insurer will have no responsibility to pay any benefits if the insured does not comply.

Additionally, insurers are entitled to seek Independent Medical Exams of the insured. If a person unreasonably fails to appear for an independent medical exam (IME), the carrier is no longer responsible for benefits. If a person refuses or fails to appear for two IME’s a rebuttable presumption is raised that the refusal or failure was unreasonable, again triggering the right by insurers to deny benefits.

The PIP reforms will not only have an impact on the amount of benefits paid but will also provide insurers a great ability to deny benefits altogether. Because of the wide reaching impacts of PIP reform, it is highly recommend that any individual involved in a motor vehicle accident contact a Tampa personal injury attorney to ensure their rights are protected.

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